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This in vitro study aimed to evaluate apical pressure during irrigant delivery with syringe irrigation in immature teeth with an open apical foramen. Conventional syringe irrigation was performed in a 3D-printed immature incisor. A 5 mL syringe combined with 25 G and 30 G cannulas was used. Open-ended and side-vented needle tip designs were assessed. Cannulas were placed at tooth length (TL), TL −1 mm, TL −2 mm, and TL −4 mm. The syringe plunger was moved with a force of 10 N, 20 N, 40 N, and 80 N to simulate clinical conditions. A pressure sensor measured periapical pressures during irrigation. Each experiment was repeated 10 times. Data were analyzed descriptively (maximum, mean, standard deviation, 95% CI) with the critical threshold indicative of extrusion set at 7.64 mbar. 30 G cannulas with both needle tip designs never exceeded the threshold at any TL with a plunger force of 10–40 N. At 80 N, 30 G open-ended cannulas exceeded the threshold in 10%, 30 G side-vented in 20–60% of the measurements. At any TL, 25 G open-ended cannulas and 25 G side-vented cannulas never crossed the threshold with forces of 10–20 N and 10 N, respectively. Consequently, 30 G cannulas with both designs can be recommended for irrigant delivery in immature teeth. 25 G cannulas ought to be used with caution. [ABSTRACT FROM AUTHOR]

A correction to the article "Is Smoking a Predictor of Apical Periodontitis?" which was published online on June 13, 2013 is presented.

Presents the guidelines for the presentation of the research poster contest at the biennial congress of the European Society of Endodontology. Content of the abstract that should come along with the poster; Mode or research papers; Procedure on how to join the contest.

Provides information regarding the regulations that govern the European Society of Endodontology's research prize for the encouragement of research related to endodontology. Title of the award the winning research work will receive; Value of the award in euro; Qualification for the contest; Bases for the selection of the winner.

Objectives: To assess the impact of the age of resin-based composite (RBC) restorations used for deep margin elevation (DME) on the marginal quality and fracture resistance of inlays. Materials and methods: Permanent human molars with direct RBC restorations, involving the mesial, occlusal, and distal surface (MOD), were allocated to four groups (each n = 12). Half of the teeth underwent thermomechanical loading including 240,000 occlusal load cycles and 534 thermal cycles (TML, 5 °C/55 °C; 49 N, 1.7 Hz). With RBC left in one proximal box as DME, all teeth received MOD inlays, made from lithium disilicate (LDS) or a polymer-infiltrated ceramic network material (PICN). The restored teeth underwent TML including 1.2 million occlusal cyclic loadings and 2673 thermal cycles. The marginal quality was assessed at baseline and after both runs of TML. Load-to-fracture tests were performed. The statistical analysis comprised multiple linear regressions (α = 0.05). Results: Simulated aging of RBC restorations had no significant effect on the marginal quality at the interface between the RBC and the tooth and the RBC and the inlay (p ≥ 0.247). Across time points, higher percentages of non-continuous margin were observed between the inlay and the tooth than between the tooth and the RBC (p ≤ 0.039). The age of the DME did not significantly affect the fracture resistance (p ≥ 0.052). Conclusions: Artificial aging of RBC restorations used for DME had no detrimental effect on the marginal quality and fracture resistance of LDS and PICN inlays. Clinical relevance: This laboratory study suggests that—in select cases—intact, direct RBC restorations not placed immediately before the delivery of an indirect restoration may be used for DME. [ABSTRACT FROM AUTHOR]

Objective: The aim was to compare the homogeneity and adaptation of endodontic fillings placed in root canals with wide apical preparation. Study design: One hundred twenty root canals were prepared under simulated clinical conditions. The range of apical preparation size was 45 (narrow canals) to 60 (wide canals). The canals were filled using 4 techniques: Thermafil, GuttaFlow, apical cone, and vertical compaction. The root canals were sectioned at 5 levels. The adaptation and homogeneity of the filling were evaluated and statistically analyzed. Results: The percentage of canal outline in contact with the filling in the Thermafil group (91.3% [95% confidence interval (CI) 88.8%-93.6%]) was statistically significantly lower than in the other groups. No statistically significant differences were found between GuttaFlow (96.6% [95% CI 95.7%-97.5%]), apical cone (98.6% [95% CI 98.0%-99.3%]), and vertical compaction (98.1% [95% CI 96.5%-99.7%]). Similarly, the percentage of void area in Thermafil group (4.0% [95% CI 2.6%-5.3%]) was statistically significantly higher than in the other groups (GuttaFlow 1.4% [95% CI 0.1%-1.8%], apical cone 1.6% [95% CI 0.7%-2.4%], and vertical compaction 0.1% [95% CI 0.1%-1.8%]). Conclusions: The tested filling techniques/materials provided similar high values for the homogeneity and adaptation to root canal walls after enlarged apical preparation, except for Thermafil at the most apical level. [Copyright &y& Elsevier]

Background: Azithromycin may be an alternative adjunctive systemic antibiotic in non-surgical periodontal therapy. Objective: This study aims to identify randomized controlled trials evaluating non-surgical periodontal treatment of chronic and/or aggressive periodontitis supplemented with systemically administered azithromycin. Materials and methods: A systematic literature search was performed for publications published by 31 March 2014 using electronic databases and hand search. Randomized controlled trials published in English or German language, with a follow-up ≥6 months were included. From 231 titles identified, nine publications were eligible for inclusion. Results: Among the studies included, showing some risk of bias, seven reported on patients with chronic periodontitis and two with aggressive periodontitis. Minor adverse events were described in five studies. A synthesis of results using a vote counting method was applied. Significant ( p < 0.05) beneficial effects of azithromycin were shown in six studies for probing depth changes and in five studies for clinical attachment level changes. Conclusion: In contrast to aggressive periodontitis patients, data from this analysis indicate a potential benefit of systemic azithromycin as adjunctive to non-surgical periodontal therapy in chronic periodontitis patients. Clinical relevance: When contraindications for the standard antibiotics are present, azithromycin (AZM) may be considered as alternative systemically administered antibiotic drug in selected cases of chronic periodontitis. [ABSTRACT FROM AUTHOR]

Objective The aim of the investigation was to contribute to the ongoing discussion at the international standardization committee on how to artificially age dental resin composite cements. Methods Indirect tensile strength ( n = 30) of a dual-cured resin composite cement (Panavia F2.0) was measured to evaluate the effect of water storage at 37 °C or thermal cycling (5 °C/55 °C/1 min) for up to 64 days. The influence of water temperature (5–65 °C) after 16 days and the effect of 1 day water storage at 37 °C prior to aging were assessed. Storage in air at 37 °C served as control. Results Thermal cycling affected the indirect tensile strength most, followed by water storage at 55 °C, whereas water storage at 37 °C had only little influence. Major deterioration occurred before day 4 (≈6000 cycles). A 1-day pre-treatment by water storage at 37 °C prior to thermal cycling attenuated the effect of aging. Significance For the material investigated, thermal cycling for 4 days is the most efficient aging procedure. A 1-day water storage at 37 °C prior to thermal cycling is recommended to allow complete polymerization. A 4-day water storage at 55 °C may be considered as a viable alternative to thermal cycling. [ABSTRACT FROM AUTHOR]

Objective: The aim if this study was to determine the minimal inhibitory concentrations of chlorhexidine digluconate and an amine fluoride/stannous fluoride-containing mouthrinse against Porphyromonas gingivalis and mutans streptococci during an experimental long-term subinhibitory exposition. Material and methods: Five P. gingivalis strains and four mutans streptococci were subcultivated for 20-30 passages in subinhibitory concentrations of chlorhexidine digluconate or an amine fluoride/stannous fluoride-containing mouthrinse. Results: Pre-passaging minimal inhibitory concentrations for chlorhexidine ranged from 0.5 to 2 mg/l for mutans streptococci and from 2 to 4 mg/l for the P. gingivalis isolates. For the amine fluoride/stannous fluoride-containing mouthrinse minimal inhibitory values from 0.125 to 0.25 % for the mutans streptococci and from 0.063 to 0.125 % for the P. gingivalis isolates were determined. Two- to fourfold increased minimal inhibitory concentrations against chlorhexidine were detected for two of the five P. gingivalis isolates, whereas no increase in minimal inhibitory concentrations was found for the mutans streptococci after repeated passaging through subinhibitory concentrations. Repeated exposure to subinhibitory concentrations of the amine fluoride/stannous fluoride-containing mouthrinse did not alter the minimally inhibitory concentrations of the bacterial isolates tested. Conclusion: Chlorhexidine and the amine fluoride/stannous fluoride-containing mouthrinse are effective inhibitory agents against the oral bacterial isolates tested. No general development of resistance against chlorhexidine or the amine fluoride/stannous fluoride-containing mouthrinse was detected. However, some strains showed potential to develop resistance against chlorhexidine after prolonged exposure. Clinical relevance: The use of chlorhexidine should be limited to short periods of time. The amine fluoride/stannous fluoride-containing mouthrinse appears to have the potential to be used on a long-term basis. [ABSTRACT FROM AUTHOR]

Objectives: The aim of this study was an analysis of the root surface roughness caused by air polishing powders containing sodium bicarbonate or glycine. Methods: The roots of human molars were sectioned into dentin discs and irradiated with three different powders: (A) sodium bicarbonate (dv50 = 62 μm), (B) glycine (dv50 = 49 μm) and (C) glycine (dv50 = 21 μm). Standardized conditions in terms of instrumentation time (5 and 10 s), pressure (1.8 bar), distance (2 and 5 mm) and angulation (45° and 90°) were applied. Surface roughness (DIN EN ISO 4287:1998) of the probes was analysed by means of the surface profile values 'Pa' and 'Pt' and the surface roughness value 'Rz'. The effect of treatment (treated vs. untreated) was studied on each disc. Geometric mean ratios (GMRs) from mixed effects models and confidence intervals (95 % CI) were calculated. Results: For Pa, the comparison revealed significant differences between powders A and B (GMR 3.57, 95 % CI 2.87-4.43, p < 0.001) and powders A and C (GMR 2.72, 95 % CI 2.20-3.37, p < 0.001) for the overall effects. With respect to Pt, significant differences occurred between powders A and B (GMR 2.49, 95 % CI 2.11-2.94, p < 0.001) and powders A and C (GMR 2.39, 95 % CI 2.03-2.82, p < 0.001). Between powders B and C, there were no significant differences for Pa, Rz and Pt. Conclusion: Air polishing powders containing glycine caused significantly less alterations on human root surfaces compared to powders containing sodium bicarbonate. Clinical significance: Powders containing glycine caused a significantly lower increase in root surface roughness compared to those containing sodium bicarbonate. Powders containing sodium bicarbonate may not be indicated for root surface treatment. [ABSTRACT FROM AUTHOR]

Objectives: To evaluate the association between cigarette smoking and the frequency of apical periodontitis in female and male patients seeking treatment at the University of Basel (KREBS Project). Materials and methods: This cohort study included full-mouth periapical radiographs of 161 subjects, including 66 current smokers, 26 former smokers and 69 individuals who had never smoked. The periapical region of all teeth was radiographically evaluated using the Periapical Index (PAI) score. Generalised linear mixed-effects models using the logit link were performed. Results: The frequency of apical periodontitis differed based on gender and smoking status. Current male cigarette smokers with <10 or ≥10 pack years showed frequencies of apical periodontitis of 12 % and 5.5 %, respectively, compared to 3.8 % in individuals who had never smoked. The corresponding data for female smokers were 5.7 % and 7.2 % in smokers with <10 or ≥10 pack years, respectively, versus 5.2 % in individuals who had never smoked. The factors 'prevalent coronal restoration' ( p < 0.001), 'prevalent root canal treatment' ( p < 0.001) and 'quality of root canal filling' ( p < 0.001) were significant predictors for apical periodontitis. After adjustment for quality of root canal filling cigarette smoking was not associated with apical periodontitis in current female and male smokers with <10 or ≥10 pack years ( p > 0.05). Conclusion: Smoking status did not predict apical periodontitis in females and males in this sample group. Clinical relevance: With respect to quality of root canal filling, tobacco use may not be a significant predictor for apical periodontitis. [ABSTRACT FROM AUTHOR]

Background Consideration of the biologic width in restorative dentistry seems to be important for maintaining periodontal health. Objective To evaluate the dimensions of the biologic width in humans. Materials and Methods A systematic literature search was performed for publications published by 28 September 2012 using five different electronic databases; this search was complemented by a manual search. Two reviewers conducted the study selection, data collection, and validity assessment. The PRISMA criteria were applied. From 615 titles identified by the search strategy, 14 publications were included and six were suitable for meta-analyses. Results Included studies were published from the years 1924 to 2012. They differed with regard to measurements of the biologic width. Mean values of the biologic width obtained from two meta-analyses ranged from 2.15 to 2.30 mm, but large intra- and inter-individual variances (subject sample range: 0.2 - 6.73 mm) were observed. The tooth type and site, the presence of a restoration and periodontal diseases/surgery affected the dimensions of the biologic width. Pronounced heterogeneity among studies regarding methods and outcome measures exists. Conclusions No universal dimension of the biologic width appears to exist. Establishment of periodontal health is suggested prior to the assessment of the biologic width within reconstructive dentistry. [ABSTRACT FROM AUTHOR]

Objectives: The aim of the present review was to analyze the impact of the hydrodynamic effects created by powered toothbrushes on biofilm removal in vitro. Materials and methods: A MEDLINE search was performed for publications published by 20 May 2012; this search was complemented by a manual search. The study selection, data preparation, and validity assessment were conducted by two reviewers. Results: Sixteen studies were included. The studies differed with respect to the methods of biofilm formation and brushing protocols. Eighteen different powered toothbrush models were evaluated. Toothbrushes with side-to-side action demonstrated biofilm removal without direct bristle contact to biofilms ranging from 38 to 99 %. Most studies found biofilm removal exceeding 50 %. Biofilm reduction using multidimensional toothbrushes was significantly lower than by those with the side-to-side mode. Detachment forces due to hydrodynamic phenomena, passing air-liquid interfaces, and acoustic energy transfer were suggested to cause reduction of the biofilm. Conclusion: Noncontact biofilm reduction was obtained by the hydrodynamic effects of some powered toothbrushes in vitro. Clinical relevance: Powered toothbrushes may have the potential to simplify self-performed oral hygiene. However, additional beneficial effects of higher amounts of noncontact biofilm removal in vitro have not been shown clinically, yet. [ABSTRACT FROM AUTHOR]

Objectives: This laboratory study aimed to assess the effects of ultrasonic instrumentation, simulating 10 years of supportive periodontal therapy (SPT), on single-unit crowns. Materials and methods: Standardized crowns were fabricated from porcelain-fused-to-metal (PFM) (n = 12), zirconia (ZrO2) (n = 12), lithium disilicate (LDS) (n = 12), feldspar ceramic (FSFC) (n = 6), and polymer-infiltrated ceramic network material (PICN) (n = 6). The crowns, luted on PICN abutments with resin-based luting material (RBLM), and if applicable glass ionomer cement (GILC), underwent thermal cycling and trimonthly ultrasonic instrumentation. After 1 and 10 years of simulated SPT, restoration quality assessments were performed, comprising profilometric surface roughness measurements, marginal integrity evaluations, and scores for luting material remnants and visible cracks. The statistical analysis included multiple logistic regressions with nested designs (α = 0.05). Results: During simulated SPT, bulk fractures (n = 2) and a de-cementation failure (n = 1) of LDS and ZrO2 crowns were observed. No significant change in roughness was detected after 10 years (p = 0.078). Over time, marginal defects increased (p = 0.010), with PFM crowns showing the highest rate of chippings at sites with a narrow shoulder. Fewer marginal defects were detectable on crowns luted with RBLM compared with GILC (p = 0.005). Luting material remnants decreased during SPT (p < 0.001). Ultrasonic instrumentation caused cracks in most crown materials, in particular at sites with a narrow shoulder and in PFM crowns. Conclusions: Repeated ultrasonic instrumentation may damage single-unit crowns. PFM crowns with a narrow, all-ceramic margin are especially prone to defects. Clinical relevance: Frequent ultrasonic instrumentation of restoration margins of fixed dental prostheses, PFM crowns in particular, ought to be avoided. [ABSTRACT FROM AUTHOR]

Objectives: This study aimed to retrospectively evaluate clinical and radiographic outcomes of partial pulpotomy performed in permanent teeth with carious pulp exposure. Materials and methods: Records of patients undergoing treatment at an undergraduate dental clinic between 2010 and 2019 were screened for partial pulpotomies in teeth with a presumptive diagnosis of normal pulp or reversible pulpitis. The follow-up had to be ≥ 1 year. Patient data were retrieved and analyzed using Mantel-Cox chi square tests and Kaplan–Meier statistics. The level of significance was set at α = 0.05. Results: Partial pulpotomy was performed in 111 cases, of which 64 (58%) fulfilled the eligibility criteria. At the time of partial pulpotomy, the mean age was 37.3 (± 13.5) years (age range 18–85). The mean observation period was 3.1 (± 2.0) years. Two early failures (3.1%) and five late failures (7.7%) were recorded. The overall success rate of maintaining pulp vitality was 89.1%, with 98.4% tooth survival. The cumulative pulp survival rates of partial pulpotomy in patients aged < 30 years, between 30 and 40 years, and > 40 years were 100%, 75.5%, and 90.5%, respectively, with no significant difference between the age groups (p = 0.225). At follow-up, narrowing of the pulp canal space and tooth discoloration were observed in 10.9% and 3.1% of cases, respectively. Conclusions: Across age groups, partial pulpotomy achieved favorable short and medium-term outcomes in teeth with carious pulp exposure. Clinical relevance: Adequate case selection provided, partial pulpotomy is a viable operative approach to treat permanent teeth with deep carious lesions irrespective of patients' age. [ABSTRACT FROM AUTHOR]

Aim: A laboratory study to determine the apical pressure generated by seven canal irrigation methods in an anterior tooth with an open apex. Methodology: Canal irrigation was performed on a 3D‐printed central maxillary incisor with an open apex (maximum diameter of 2.1 mm). Ultrasonically activated irrigation (UAI), sonic activation (EDDY), negative pressure irrigation (EndoVac), the self‐adjusting file (SAF) and the XP‐endo Finisher were employed at tooth length (TL), TL—1 mm, TL—2 mm and TL—3 mm. UAI was tested at three intensity levels additionally. Hydrodynamic irrigation with RinsEndo was performed in the pulp chamber, at the canal orifice, the coronal third, the middle of the canal and at TL. Er:YAG laser activation, at four frequency settings, was performed in the pulp chamber and at the orifice of the canal. The pressure of the fluid towards the canal terminus generated by activation was directly transferred to a pressure sensor with a range of 0 to 120 mmHg and a response time of ≤0.5 ms. The critical threshold for apical extrusion of the irrigant was set at 5.73 mmHg (lower limit of the central venous pressure: 5.88 ± 0.15 mmHg). Each experiment was repeated ten times. The tests were followed by descriptive analyses (maximum, mean, standard deviation, 95% confidence interval). Results: EndoVac, the SAF, the XP‐endo Finisher, and UAI never exceeded the critical threshold at any insertion depth or intensity level. Er:YAG laser activation exceeded the critical threshold exclusively at frequency settings that varied from the manufacturer's recommendation. EDDY at TL and RinsEndo at any insertion depth exceeded the critical threshold in 100% of the measurements. EDDY at TL—1,—2, and—3 mm crossed the critical threshold in 30%, 10%, and 20% of the measurements, respectively. Conclusions: In a simulated maxillary central incisor with an open apex, irrigation with EndoVac, Er:YAG laser activation, UAI, the SAF, and the XP‐endo Finisher generated apical pressures below the critical threshold of 5.73 mmHg. By contrast, using EDDY and RinsEndo for irrigation produced higher apical pressures that exceeded the critical threshold. [ABSTRACT FROM AUTHOR]

Objectives: This study aimed to assess whether the emergency service of a major Swiss dental institution faced different demands (patient volume, treatment needs, dental care characteristics) during a lockdown, issued to mitigate the COVID-19 pandemic, compared with the weeks before and after. Materials and methods: Data of patients receiving urgent care at a university center for dental medicine (Basel, Switzerland) during the 6-week lockdown, pre-lockdown, and post-lockdown periods were retrospectively evaluated. Statistical analysis involved tests for equal proportions and logistic regression models. The level of significance was set at α=0.05. Results: The study comprised 3109 dental emergency visits in the period from February 2 to June 5, 2020. Daily caseloads increased during lockdown. Abscesses, orthodontic emergencies, and surgical follow-ups were more common during lockdown, whereas the number of dento-alveolar injuries declined (≤0.048). Urgent dental care provision involved intraoral radiographs more frequently in the pre-lockdown period compared with the following weeks (p<0.001). Among all treatments, aerosol-generating procedures dropped from 56.1% (pre-lockdown) to 21.3% during lockdown (p<0.001), while teledentistry follow-ups became more frequent (p<0.001). Patients with comorbidities sought urgent dental care less frequently during the post-lockdown period (p=0.004). Conclusions: The lockdown significantly impacted the dental emergency service in terms of patients' diagnoses, treatment needs, and the characteristics of the urgent care that was delivered. Clinical relevance: Access to essential dental care must be monitored and safeguarded throughout the COVID-19 pandemic and beyond as deferred care entails risks for serious sequelae and persons with comorbidities may change their dental care-seeking behavior. [ABSTRACT FROM AUTHOR]

Objectives: This in vitro study aimed to assess the influence of a calcium hydroxide dressing regarding the relative color change (ΔE) of enamel–dentin specimens previously exposed to antibiotic/corticosteroid pastes. Materials and methods: Eighty bovine enamel–dentin specimens with a cylindrical central cavity were randomly allocated to four groups: NEG (empty), POS (blood), LED (Ledermix), and ODO (Odontopaste) (n = 20 each). The materials were applied and sealed with self-adhesive resin luting material. After 3 weeks, the materials were removed and a calcium hydroxide (Ca(OH)2) dressing was placed in all cavities. After a further 3-week storage period, the cavities were restored with resin-based composite. Spectrophotometric color measurements were taken over 6 months, and ΔE values were calculated. A Tukey's multiple comparison test was performed to assess significant differences within the treatment groups (p < 0.05). Results: Tooth discolorations were present after 3 weeks in LED (ΔE 29.14 ± 6.55) and POS (ΔE 18.05 ± 7.03); NEG and ODO remained color stable (ΔE 3.2 ± 1.36 and ΔE 2.3 ± 1.16). The 3-week Ca(OH)2 dressing decreased discolorations of POS (ΔE 15.93 ± 6.63; p = 0.37), whereas LED showed a further significant increase (ΔE 39.55; p < 0.0001). Between the end of the Ca(OH)2 dressing and the final restoration no significant color changes were observed in any group (p > 0.9). Conclusions: Discolorations induced by LED progressed during the Ca(OH)2 dressing despite careful removal of all residues. Clinical relevance: Calcium hydroxide might negatively affect the discoloring potential of Ledermix. This highlights the need for direct intracanal application methods of Ledermix ensuring a material-free access cavity or alternative antibiotic/corticosteroid pastes such as Odontopaste should be used. [ABSTRACT FROM AUTHOR]

Objective: This study aimed to examine saliva flow rates and prevalence of dental and periodontal diseases of patients with newly diagnosed severe haematological diseases and compare these findings with age-matched controls of normal population. Methods: A total of 149 patients diagnosed with haematological diseases aimed to be treated with haematological stem cell transplantation between 2008 and 2018 and 154 controls were included in the study. A dental examination was performed for patients within a maximum of 6 months after diagnosis. Differences were compared in terms of the stimulated salivary flow rate (SSFR); decayed, missing and filled teeth (DMFT) index; number of teeth; caries prevalence; presence of periodontitis and acute infections. Results: The mean SSFR of the patient group was significantly lower (1.1 ml/min ± 0.7 ml/min) than the mean SSFR of the controls (1.3 ml/min ± 0.5 ml/min; p = 0.004). The number of caries lesions was significantly higher in the patient group (mean ± SD, 1.1 ± 1.9) than in the control group (mean ± SD, 0.4 ± 1.2; p < 0.001). There were fewer teeth and a higher DMFT index in the patient group compared to the control group, but the differences were not significant. Acute symptomatic infections were observed in eight (5.4%) patients and in none of the controls (p < 0.01). Conclusions and clinical relevance: Oral examinations in patients with newly diagnosed severe haematological disease demonstrated a higher prevalence of caries, acute infections and lower mean SSFR compared with the controls. These findings support the recommendations for early dental examination at the time of diagnosis. [ABSTRACT FROM AUTHOR]

Objectives: To investigate the impact of the lateral deflection of toothbrush bristles (amplitude) of three side-to-side toothbrushes for noncontact biofilm removal in an artificial interdental space model.Materials and methods: A three-species biofilm (Porphyromonas gingivalis, Fusobacterium nucleatum, Streptococcus sanguinis) was formed in vitro on protein-coated titanium disks. A flow chamber system was combined with a static biofilm growth model. The amplitudes of three commercial side-to-side toothbrushes were evaluated by means of a dose response analysis. The amplitudes were decreased in steps (100%, 85%, 70%, 55%, and 40%). Subsequently, the biofilm-coated substrates were exposed to the toothbrushes. The biofilms were analyzed with confocal laser scanning microscope images and measured using volumetric analyses.Results: The predictability of interdental biofilm reduction differed among the toothbrushes. A lower variety in the results of repeated experiments occurred in toothbrush C compared to toothbrushes A and B. Toothbrush C obtained highest percentage of biofilm reduction by 85% of amplitude power setting (median biofilm reduction 76%). Decreasing the amplitude from 85 to 40% resulted in reduced biofilm reduction (p = 0.029). In contrast, no significance could be observed for the differences of the tested amplitudes within toothbrushes A and B (p > 0.05). Between the toothbrushes, a significant difference in interdental biofilm reduction was found between C-A (p = 0.029) and C-B (p = 0.029) with amplitude of 85%.Conclusions: The amplitude of one of the investigated side-to-side toothbrushes affected the biofilm reduction predictably in an interdental space model.Clinical relevance: Within certain toothbrushes, a specific amplitude power setting may demonstrate beneficial effects on noncontact biofilm removal. [ABSTRACT FROM AUTHOR]

Objectives: The objective of this study was to investigate the influence of different oscillation frequencies of three powered toothbrushes with side-to-side action for noncontact biofilm removal in an artificial interdental space model.Materials and methods: A three-species biofilm (Porphyromonas gingivalis, Fusobacterium nucleatum and Streptococcus sanguinis) was formed in vitro on protein-coated titanium disks using a flow chamber system combined with a static biofilm growth model. The oscillation frequencies of three commercial side-to-side toothbrushes were evaluated by means of a dose response. The frequency was decreased in steps (100, 85, 70, 55, and 40%). Subsequently, the biofilm-coated substrates were exposed to the side-to-side toothbrushes. The biofilm volumes were measured using volumetric analyses (Imaris 8.1.2) with confocal laser scanning microscope images (Zeiss LSM700).Results: Compared to maximum oscillation frequency (100%), lower oscillation frequencies (up to 40%) resulted in reduced median percentages of biofilm reduction (median biofilm reduction up to 53% for maximum oscillation frequency, and up to 13% for 40% oscillation frequency) (p ≥ 0.03). In addition, decreasing the oscillation frequencies of the side-to-side toothbrushes showed an enhanced variety in the results of repeated experiments.Conclusions: The oscillation frequency of the tested side-to-side toothbrushes affected the biofilm reduction in an interdental space model.Clinical relevance: Within a toothbrush, higher oscillation frequencies may lead to beneficial effects on interdental biofilm removal by noncontact brushing. [ABSTRACT FROM AUTHOR]

Aim: The aim of this study was to compare the interproximal bone level at root canal-filled teeth and non-root canal-filled teeth. Materials and methods: The records of patients from the department were consecutively screened from January 2009 to October 2011. The distance between the coronal reference point to the alveolar bone crest (AC) was assessed at the mesial and distal aspects of root canal-filled teeth (RCF+) and their contralateral non-root canal-filled teeth (RCF−) on periapical radiographs. Generalised linear mixed-effects models were applied. Results: The sample consisted of 128 pairs of teeth comprising data from 72 patients. The results for AC revealed a median distance of 3.2 mm for RCF+ and 3.4 mm for RCF− ( p = 0.61). Using the maximal distance on either the distal or the mesial tooth surface, a median distance of 3.6 mm was detected for RCF+ and 3.8 mm for RCF−, respectively ( p = 0.42). Even after taking several tooth- and subject-specific variables into account, the differences between AC on RCF+ and RCF− were statistically not significant ( p > 0.05). Conclusion: The interproximal bone loss did not differ statistically significant between root canal-filled teeth and non-root canal-filled teeth. Clinical relevance: Existence of appropriately done root canal fillings in periodontitis patients has no effect on the prognosis of periodontal disease. [ABSTRACT FROM AUTHOR]

Objective The aim of this systematic review was to assess the role of excess cement as risk indicator for peri-implant diseases. Material and methods A systematic literature search with the keywords peri-implant disease, peri-implant mucositis, peri-implantitis, excess cement, cemented, and screw-retained restorations was performed for articles published by June 2016 using MEDLINE and EMBASE electronic databases, complemented by hand searching. Results The included 26 publications referring to 21 study groups were published between 1999 and 2016 and comprised 945 subjects with 1010 cemented implant restorations in 10 prospective and eight retrospective studies and eight case reports/series with pronounced heterogeneity of the study designs. Prevalence of peri-implant diseases varied between 1.9% and 75% of the implants with cemented restorations, with proportions of 33-100% associated with excess cement. In publications including early follow-ups and regular recall intervals, peri-implant disease was mostly detected at an early stage. Cofactors, such as type of abutment (standardized or individualized) and cementum medium used, did not have a significant influence, while higher prevalence of peri-implant diseases was found with immediate loading or cementation subsequent to reentry, and with cemented vs. screw-retained restorations. Conclusions Excess cement was identified as a possible risk indicator for peri-implant diseases and was more frequently observed with soft tissue healing periods shorter than 4 weeks. To reduce the risk of peri-implant disease associated with excess cement, a crown margin at the level of the mucosal margin providing sufficient access is recommendable, and soft tissue maturation and early follow-ups after restoration placement should be assured. [ABSTRACT FROM AUTHOR]

Objectives: This systematic review analyzed the relationship between periapical and periodontal pathologies in the posterior maxilla and the appearance of the Schneiderian membrane in cone-beam computed tomography (CBCT) compared with sound dentitions. Methods: Five electronic databases (Cochrane Library, Embase, OpenGrey, PubMed, Web of Science), complemented by hand searching, were screened up to May 9, 2016. Human clinical studies that used CBCT and contained information on the periapical/periodontal status in the posterior maxilla and Schneiderian membrane appearance were included. A weighted vote counting (WVC) method was applied to summarize results across studies. Results: Out of 413 records, 20 studies were included. In the WVC, the studies that observed a positive association between periapical lesions and the appearance of the Schneiderian membrane outweighed those that found no such association (WVC 51 % and WVC 33 %, respectively), with some studies yielding indeterminate results (WVC 16 %). Regarding the relation between periodontal pathologies and the appearance of the Schneiderian membrane, WVC produced a tie between studies demonstrating a positive association (WVC 46 %) and those showing no association (WVC 44 %); one study (WVC 10 %) reported indeterminate results. Conclusions: On CBCT scans, periapical lesions in the posterior maxilla are likely to be associated with Schneiderian membrane thickening. In contrast, current evidence regarding the relation between periodontal diseases and the appearance of the Schneiderian membrane in CBCT is inconclusive. Clinical relevance: Incidental maxillary sinus findings on CBCT scans warrant thorough differential diagnosis. Frequently, they may be related to dental pathologies. [ABSTRACT FROM AUTHOR]

Objectives: The objective of this study was to evaluate the efficacy of four different side-to-side toothbrushes and the impact of various brushing parameters on noncontact biofilm removal in an adjustable interdental space model. Materials and methods: A three-species biofilm, consisting of Porphyromonas gingivalis, Fusobacterium nucleatum, and Streptococcus sanguinis, was formed in vitro on protein-coated titanium disks using a flow chamber combined with a static biofilm growth model. Subsequently, the biofilm-coated disks were exposed to four different powered toothbrushes (A, B, C, D). The parameters distance (0 and 1 mm), brushing time (2, 4, and 6 s), interdental space width (1, 2, and 3 mm), and toothbrush angulation (45° and 90°) were tested. The biofilm volumes were determined using volumetric analyses with confocal laser scanning microscope (Zeiss LSM700) images and Imaris version 7.7.2 software. Results: The median percentages of simulated interdental biofilm reduction by the tested toothbrushes ranged from 7 to 64 %. The abilities of the analyzed toothbrushes to reduce the in vitro biofilm differed significantly ( p < 0.05). Three of the tested toothbrushes (A, B, C) were able to significantly reduce a simulated interdental biofilm by noncontact brushing ( p ≤ 0.005). The brushing parameters and their combinations tested in the experiments revealed only minor effects on in vitro interdental biofilm reduction ( p > 0.05). Conclusions: A three-species in vitro biofilm could be altered by noncontact brushing with toothbrushes A, B, and C in an artificial interdental space model. Clinical relevance: Certain side-to-side toothbrushes demonstrate in vitro a high efficacy in interdental biofilm removal without bristle-to-biofilm contact. [ABSTRACT FROM AUTHOR]

Aim To present a new treatment approach for teeth with pulp canal calcification ( PCC) which require root canal treatment. Case A 15-year-old male patient presented with pain of his upper right central incisor. The tooth showed signs of apical periodontitis. Due to PCC, location of the root canal was judged to be difficult and associated with a high risk of perforation. A cone beam computed tomography ( CBCT) and an intra-oral surface scan were performed and matched using software for virtual implant planning. After planning the position of the drill for root canal location, a virtual template was designed, and the data were exported as an STL file and sent to a 3D printer for template fabrication. The template was positioned on the anterior maxillary teeth. A specific drill was used to penetrate through the obliterated part of the root canal and obtain minimally invasive access to the apical part. The root canal was accessible at 9 mm distance from the apex. Further root canal preparation was carried out using an endodontic rotary instrumentation system. After an interappointment dressing for 4 weeks, the root canal was filled with vertically condensed gutta-percha using an epoxy sealer. The access cavity was restored with a composite material. After 15 months, the patient was clinically asymptomatic with no pain on percussion. The radiograph showed no apical pathology. Conclusions The presented guided endodontic approach seems to be a safe, clinically feasible method to locate root canals and prevent root perforation in teeth with PCC. [ABSTRACT FROM AUTHOR]

Aim Periodontal diseases ( PDs) may play an important role in the effect oral health status has on a person's quality of life (QoL). The objective was to investigate the influence of PDs (gingivitis and periodontitis) on oral health-related QoL ( OHRQoL) by systematically reviewing the literature. Materials and Methods Studies using clinical periodontal examinations and validated survey instruments were included. Among 1134 citations initially identified through electronic and hand searching, 37 were eligible and data were extracted from full texts. A vote counting method was used for synthesis of the results. Results Included studies were published between 2001 and 2014 and revealed considerable heterogeneity in participant selection, clinical assessments, and OHRQoL measures. A significant association between PDs and OHRQoL was reported in 28 studies, of which eight reported increasing impact with greater disease severity or extent. Conclusions Within the limits of the available literature, OHRQoL was affected by clinically assessed PDs. There was evidence for increased impairment with greater severity and extent of PDs, and the recognition of the association was increased when full mouth recording protocols were applied. [ABSTRACT FROM AUTHOR]

Objectives: The aim of this study is to investigate the influence of changing the sodium perborate-tetrahydrate (PBS-4) at a 4-day interval versus no change after 16 days of internal bleaching. Materials and methods: Two hundred and ten bovine enamel-dentin discs were discolored for 3.5 years with 14 different endodontic materials. All groups with a discoloring index of ∆ E ≥ 5.5 were included in the present investigation: ApexCal (APCA), MTA white + blood (WMTA+BL), Portland cement + blood (PC+BL), blood (BL), MTA gray (GMTA), MTA gray + blood (GMTA+BL), Ledermix (LED), and triple antibiotic paste containing minocycline (3Mix). Fourteen specimens of each group were randomly assigned into two treatment groups: (1) no change of the PBS-4 ( n = 7); (2) change of the PBS-4 every 4 days ( n = 7). Color measurements were taken at 10 different time intervals and the L* a* b* values were recorded with a spectrophotometer (VITA Easyshade® compact). Results: In the group 3Mix, significantly better results were achieved by changing the bleaching agent every 4 days ( P = 0.0049; q = 0.04), while the group WMTA+BL indicated better results by no change of the bleaching agent ( P = 0.0222, q = 0.09). All remaining groups showed no statistical difference between the two treatment procedures. Conclusions: Moderate discolorations can be successfully treated without changing the bleaching agent over a period of 16 days. Changing the sodium perborate-tetrahydrate every 4 days is preferred in case of severe discolored enamel-dentin discs only. Clinical relevance: This approach may offer a reduced number of clinical appointments and a secondary cost reduction to the patient. [ABSTRACT FROM AUTHOR]